[Incremental peritoneal dialysis: a common solution for different types of patients]

Area of Science:

• Nephrology
• Renal Replacement Therapy

Context:

• Peritoneal dialysis initiation strategies are debated.
• Low-dose dialysis may offer benefits but requires careful consideration of adequacy targets.

Purpose:

• To evaluate the feasibility and safety of incremental peritoneal dialysis.
• To identify patient populations who may benefit from low-dose dialysis initiation.

Summary:

• Incremental peritoneal dialysis is feasible and safe in asymptomatic patients with GFR < 6 mL/min, requiring strict residual renal function monitoring.
• It can preserve residual renal function in older patients (GFR 6-10 mL/min) and benefit cardiac patients (GFR > 10 mL/min) by improving cardiac function and reducing hospitalizations.
• Adequacy targets for depuration, ultrafiltration, and electrolyte balance must be met with incremental peritoneal dialysis.

Impact:

• Incremental peritoneal dialysis presents a viable therapeutic option for nephrologists to consider.
• This approach may enhance patient quality of life and reduce complication rates in specific patient groups.
• Preservation of residual renal function and gradual patient training are potential advantages.